individual-level determinants of health (such as biologic and physiologic factors and health behaviors) from broader determinants of health (such as environmental and social determinants) (see, for example, Dahlgren and Whitehead, 1991; Evans and Stoddart, 1990; IOM, 2000). Such an approach is better suited to understanding not only the pathophysiology of a health outcome but also preventive measures that can help to ensure optimal health. When summarizing advances in the understanding of the biology and pathology related to women’s health in Chapter 3, however, the committee organized findings by health outcome in light of the nature of the literature reviewed.

The committee did not conduct a comprehensive review of all research on all diseases, disorders, and conditions that are women’s health issues. It reviewed data on the status of women’s health in terms of morbidity and mortality, and it assessed improvements in those respects in the context of research that has been conducted on the various diseases and health issues. The overall leading causes of death in women from 1989 through 2006 are presented in Appendix B. The committee focused its review in Chapter 3 on progress that has been made in reducing mortality or morbidity associated with specific conditions. The committee also highlights a few conditions or diseases in which little progress has been made so that it can identify lessons learned and future needs.

Because the incidence and prevalence of conditions and the leading causes of mortality in women vary with age, it is important to remember that the main causes of death in women overall do not necessarily reflect the main health concerns and issues at different points in a women’s life cycle and that events that occur in one stage can affect health later in life. Furthermore, women have a longer life expectancy than men so many diseases of aging are of a greater concern for women than men.

The population of women in the United Sates is diverse and growing more so. As can be seen in Appendix B, demographic groups vary in the prevalence, incidence, and severity of conditions and their determinants. The committee has reviewed the data on disparities to determine whether research is being conducted on appropriate populations of women. The committee recognizes that different groups of women (such as lesbians,9 military and veterans, prisoners, and disabled women) can have different health needs or benefit from different means of meeting their health needs. The committee has not compiled a comprehensive list of such populations but discusses the needs of particular groups as appropriate when data are available. Finally, in addition to health conditions, the committee considered such emerging issues as genetics and the effect of health information technology.

9

The IOM is currently preparing a report on lesbian, gay, bisexual, and transgender health issues as well as research gaps and opportunities.



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